Ureteric and bladder injuries are uncommon, difficult todiagnose and rarely occur in isolation. Diagnosis is oftendelayed or missed at presentation. Therefore, high clinicalsuspicion and appropriate timing of computed tomography(CT) are of paramount importance. We report two cases(ureteropelvic junction avulsion and ruptured dome ofbladder) whereby the presentations were subtle and wouldhave been missed if not for high clinical suspicion. Thisarticle discusses the problems associated with theseurologic injuries, as well as how to develop a high index of suspicion based on the pattern of anatomical disruption,mechanism of injury, physiological abnormality andcomorbidity.